Browsing by Author "Harty, Michal"

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    A case study of emerging practice in speech-language therapy in a community practice context
    (2019) Abrahams, Kristen; Kathard, Harsha; Pillay, Mershen; Harty, Michal
    Background: The profession of speech-language therapy (SLT) continues to struggle with challenges around equity and service delivery. The dominant medical model, characterised by one-on-one, individualised health care, is struggling to serve the large population in need of services. As such, there is a need to reconceptualise SLT practices toward a social justice focus. The study used clinical education as the entry point of exploration into how emerging professional practices (EPPs) may be developed. Aims/Objectives: The study aimed to describe and analyse a case study of an emerging professional practice in SLT as part of a university-school partnership in a peri-urban settlement in South Africa. The objectives were: 1. To describe and analyse the practice methods of the EPP, 2. To describe and analyse the educational and knowledge bases which support the EPP, and 3. To describe and analyse the underlying epistemology, ontology and methodology underpinnings shaping the EPP. Method: A qualitative case study methodology, guided by critical theory and decoloniality, was used. Final year SLT students were the primary participants for the study. Data were collected in the form of document analyses, participant observations, interviews, photovoice, and experiential drawings from a number of stakeholders (including SLT students, a school principal, a project coordinator, a library assistant and a clinical educator) from January to December 2017. The data were analysed using reflexive interpretation (Alvesson & Sköldberg, 2009) as a guiding frame. Findings: The three-level analysis process was used to generate the thesis offering. The first level of analysis was the construction of the overall case narrative - documenting the practice methods of the EPP through the experiences of the SLT students. The second level of analysis used thematic analysis approach to identify key themes emerging from the case narrative. Four key themes were explored in the form of narratives, collages and paintings. The third level of analysis used decoloniality (i.e. coloniality of power, knowledge and being) and the Relationship of Labouring Affinities (RoLA) as critical lenses to deepen my understanding of the case. Through using both RoLA and decoloniality, dialogue emerged as a critical form of engagement toward developing EPPs. The study specifically puts forward the concept of critical dialoguing as a necessary process for conscientisation and change. Conclusion: The findings of the study illuminated how SLT students navigated through their experiences of disruption of their traditional practice. The findings weave together participant narratives, drawings and collages to engage the reader in the EPP. The findings showed how critical engagement with political, historical, social and linguistic influences underlying their work in communication, facilitated new learning and insight into SLT practice. The thesis offering discusses the role of critical dialoguing in opening up space for critical discussions about the profession. In conclusion, supported disruption provided students with a platform to interrogate current SLT practices, re-examine the viability of practices to serve populations, and reflect on how the SLT profession can adapt and change with the changing needs of the population.
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    An exploration of the facilitators and barriers experienced by Rehabilitation Care Workers in the provision of Speech-Language Therapy related services
    (2018) Higgs, Salma; Harty, Michal; Norman, Vivienne
    Background: South Africa experiences a severe shortage of speech-language therapists (SLTs) which results in individuals requiring Speech-Language Therapy (SLT) services having to travel long distances or being placed on long waiting lists to access services. Rehabilitation Care Workers can assist with bringing this service closer to the communities they serve. It is important to explore the experiences of these individuals to ensure that they are adequately supported and skilled. The University of Cape Town (UCT) has been training Rehabilitation Care Workers (RCWs) since 2012, however to there is currently no empirical data documenting the facilitators and barriers experienced by RCWs in their work. Aim: To explore RCWs (in the Mitchells Plain/Klipfontein sub-structure) perceptions of the facilitators and barriers in providing SLT related activities in their work context. Methods: A descriptive exploratory study was conducted. Eighteen RCWs were approached and 13 participated in 2 focus groups. Data was transcribed and analysed using thematic analysis. An inductive approach was used to develop meaningful themes and sub-themes. Results: The plot of “vital role players” best synthesized the 3 main themes namely scope of practice, RCW position and value as an intrinsic motivator and challenges. : The scope of practice theme included 4 sub-themes namely, RCW activities; awareness of broad scope; understanding family needs; including family as stakeholders in patient management. RCW position and value as an intrinsic motivator - included 4 sub-themes namely, integral members of the team; agents for change; community servants; go between formal structures and the community. Finally the theme challenges –included 4 sub-themes namely, training gaps; safety; lack of resources; feeling undervalued. The facilitators and barriers identified by the RCW’s aligned with perceptions of other mid-level health care workers as reported in the literature. Implications: RCWs work within a family centred care approach and see themselves as community servants who bring vital rehabilitation services into homes by transferring their skills to families and communities through education, support and advocacy. Despite their value and passion, RCWs feel undervalued by those around them, including management structures and the Department of Health (DOH). Conclusion: RCWs can bring much needed rehabilitation services into the homes of communities in Cape Town. For this reason, it is imperative to consider the facilitators and barriers experienced by these individuals in order to harness their natural skills and strengthen the current RCW service and solidify their roles within the Multidisciplinary Team (MDT).
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    An exploration of the occurrence of speech sound disorders in children with autism spectrum disorder aged 4;0 ? 7;11 years
    (2023) Kapoutsis, Stefania; Harty, Michal
    Language development in children with autism spectrum disorder (ASD) is an area of study that has received a lot of attention, however there is limited research available on speech development in this population. There is especially limited research that has investigated speech sound disorders (SSDs) in children with ASD in South Africa. This study aimed to describe the type of SSDs children with Autism Spectrum Disorders (ASD) aged 4;0 – 7;11 years present with. The study employed a descriptive, exploratory research design. Twentyfive children aged 4;0 – 7;11 years with a diagnosis of ASD, attending English-medium schools in the Southern Suburbs of Cape Town, South Africa, participated in the study. The findings were described based on the classifications of SSDs (using Dodd's (2005) differential diagnostic framework), intelligibility ratings, production of phonemes and phonotactic structures, the occurrence of phonological processes, oro-motor ability, and prosody. Phonological delays were the most commonly occurring SSDs, this was followed by articulation disorders, phonological disorders and inconsistent phonological disorders. No participants in the sample were diagnosed with childhood apraxia of speech (CAS). The findings suggested that children with ASD appear to acquire vowels, consonants and phonotactic structures at the same trajectory as typically developing children. Variations in the acquisition of fricatives, affricates and liquids were observed. Substitution, syllable and atypical phonological processes were observed across the sample. A higher prevalence of delayed and atypical phonological processes were observed in the sample of children with ASD, compared to the norms available for typically developing children. The results of this study have indicated that while children with ASD acquire phonemes at the same rate as their typically developing peers, children with ASD may be more likely to present with SSDs. These findings highlight the need for SLTs to ensure that accurate speech assessments are carried out among this population, rather than focusing solely on language. This study is a starting point for further research to be carried out on speech development and SSDs in children with ASD.
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    App-based intervention for children with reading difficulties : a description of five cases
    (2014) Kaplan, Gaby; Pascoe, Michelle; Harty, Michal
    This descriptive single subject intervention study aimed to describe the outcomes of an application (app)-based intervention for five children with reading difficulties. All participants were required to have a grade one reading level. Each participant’s language and literacy profiles are detailed in accordance with developmental and information processing models, and intervention was designed based on each child’s specific level of difficulty. Following a baseline control period, each child received approximately six weeks of intervention using the Reading TherAppy and/or Comprehension TherAppy app (Tactus Therapy Solutions) on an iPad ® mini, which was mediated by the researcher on a 1:1 basis. Treated and untreated probe items were administered at three points in the study (baseline, pre, post) in order to determine the effects of intervention on treated and untreated, matched items. Each child’s reading on standardized literacy measures was re-evaluated post intervention. This was followed by an interview with each participant to obtain information about his or her experience of the intervention. Results show that all participants improved their reading of items treated in the intervention. In addition, some of the participants’ standardized reading and spelling scores improved in relation to typically developing peers from pre to post intervention testing. Changes are detailed for each participant using the theoretical models. Child interviews indicated that all children enjoyed a positive experience of intervention. This study aimed to explore and contribute to the limited knowledge base on efficacy, optimal dosage and outcomes of app-based intervention for children with reading difficulties. The implications of the study are discussed in relation to Speech Language Therapists working in educational settings, the functional application of models of reading, and the reading intervention literature.
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    Communication supporting environments of Grade R classrooms in a rural district of the Western Cape
    (2016) Parusnath, Prianka; Kathard, Harsha; Harty, Michal; O'Carroll, Shelley
    This study aims to describe the communication environment in Grade R classes in a rural district setting in the Western Cape in terms of language-learning environment; language-learning opportunities and language-learning interactions in order to identify areas of strengths and weaknesses. In addition to this, the study aims to explore the relationship between communication environments and school performance in a rural district in the Western Cape as well teacher and classroom variables. In order to do this, an observational tool, the Communication Supporting Classrooms Observational Tool, was used which allowed researchers to document what was happening in the classroom over the prescribed observation period (Dockrell, Bakopoulou, Law, & Spencer, 2010). Before this, the pilot phase of the study allowed researchers to train assistants to use the tool using video recordings as well as to ascertain the tool's applicability to South African classrooms with different languages of learning and teaching. A sample size of 60 classrooms was used in the main phase, consisting of 30 lower performing schools and 30 higher performing schools. The study included all regular learners and regular classroom teachers in the chosen Grade R classrooms in a rural/remote district. Overall, the outcomes of the pilot study were two-fold: (1) The researchers determined that the tool could be used reliably in classrooms where Afrikaans and isiXhosa were the language of instruction due to high inter-rater reliability measured by ICC; and (2) With sufficient training and practical examples, raters can be trained to use the tool effectively. In addition to these outcomes, the results of the pilot study allowed researchers to make useful choices for the main study. The study indicated that the tool was applicable in classrooms where Afrikaans and isiXhosa were the medium of instruction which allowed researchers to include these classrooms in the sample for the main study.
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    The effects of parent training interventions on parental self-efficacy for parents with young children with an autism spectrum disorder or other developmental disabilities : a systematic review
    (2016) Hohlfeld, Ameer Steven-Jörg; Harty, Michal; Engel, Mark E
    Background: A leading research priority worldwide is the need to improve the lives of those with disabilities through the effective development of interventions that can be carried out by non-specialists. Recent research has indicated that parent training interventions have shown to benefit both children with, and parents of children with disabilities. Aims: This systematic review sought to assess the effectiveness of interventions aimed at increasing parental self-efficacy levels in parents of young children with developmental disabilities. Methods and Procedures: We conducted a broad literature search across a number of databases to identify all relevant prospective studies meeting our study objective. Articles were selected using predefined criteria and data were extracted onto a purposely-designed data extracted form.
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    Implementing a group intervention programme emphasising early communication stimulation with parents of children with autism spectrum disorder
    (2020) Osman-Kagee, Aneesa; Harty, Michal
    Introduction: Implementing low-intensity interventions, such as group-based parent education and training (PET), is a cost and time effective way of providing early intervention for families and their children with autism spectrum disorder (ASD) in low- and middle-income countries (LMICs). Relatively little empirical research demonstrates the effectiveness of parent education and training in this context. Methods: The study aimed to develop and pilot a group-based parent education and training (PET) programme (COMPAS) and determine its appropriateness and acceptability. Secondly, it aimed to investigate the clinical effectiveness of the programme to improve the communication interaction skills and self-efficacy beliefs of parents of young children with autism. The study followed an exploratory sequential mixed methods research design and used the Replicating Effective Programs (REP) framework. Sixty-one participants took part in the study which consisted of 3 phases. In phase one we developed the programme and teaching materials and activities. In the pre-implementation phase, we collected qualitative and quantitative data via questionnaires from two stakeholder groups (25 parents and 5 autism experts). In the implementation phase, we used a single group pre-test post-test design with 31 parents of children with autism to determine changes in parent-child interaction and parenting self-efficacy. The primary outcome of the implementation phase, parent-child interaction, was measured using the Parenting Interactions with Children: Checklist of Observations Linked to Outcomes (PICCOLO), and the secondary outcome, parenting self-efficacy, was measured using the Parenting Sense of Competence Scale (PSOC) and the Parenting Self-Efficacy Measuring Instrument (P-SEMI). Results: In the pre-implementation phase, a panel of experts agreed the training content was comprehensive and relevant, and that the manual was user-friendly. After the pilot study parents felt confident that they could use at least one of the strategies taught during everyday routines or play with their child. Results from the implementation phase indicated significant improvement in parenting interactions (p < .05, d = 1.26) and self-efficacy (p < .05, d = 0.35) after the training. Conclusion: We developed and piloted a training programme in a LMIC setting which resulted in increased interaction skills and self-efficacy for parents of young children with autism. This study indicates that brief, group parent education and training in a LMIC is feasible and can be effective in improving parenting skills and feelings of competence.
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    Primary school teachers' opinions and attitudes towards stuttering in two socio-economic quintiles within the Western Cape
    (2015) Abrahams, Kristen; Kathard, Harsha; Harty, Michal
    Teachers form an important part of the multidisciplinary team as one of main communication intervention partners for children who stutter (CWS). Teachers' attitudes towards stuttering are therefore important as attitudes are likely to influence behaviour. Through determining their attitudes as well as examining the factors influencing their attitudes, speech - language therapists will be able to develop and implement professional development programmes specifically tailored for teachers, if needed. The primary aim of the study is to describe primary school teachers' attitudes toward stuttering related to their beliefs, reactions and classroom management strategies. Furthermore, it compares South African teachers' attitudes to the Public Opinion of Human Attributes – Stuttering (POSHA-S) database archive. As a secondary aim, the study explores the association between selected demographic factors and participants' attitudes toward stuttering. A quantitative, cross - sectional survey design was used. The POSHA-S was administered to a cluster randomised sample of 469 participant s in two education districts in the Western Cape. The results indicated an overall positive attitude toward stuttering. The attitudes of the South African sample were slightly more positive compared with the samples in current POSHA-S database. Analysis of the selected demographic factors revealed significant results for the teaching – related factors: quintile and years of teaching experience, and for personal factors: gender, first language, familiarity and age. The implications of these data for planning professional development programmes specifically tailored for the South African context are discussed.
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    A Situational Analysis of Current Speech-Synthesis Systems for Child Voices: A Scoping Review of Qualitative and Quantitative Evidence
    (2022-06-01) Terblanche, Camryn; Harty, Michal; Pascoe, Michelle; Tucker, Benjamin V
    Background: Speech synthesis has customarily focused on adult speech, but with the rapid development of speech-synthesis technology, it is now possible to create child voices with a limited amount of child-speech data. This scoping review summarises the evidence base related to developing synthesised speech for children. (2) Method: The included studies were those that were (1) published between 2006 and 2021 and (2) included child participants or voices of children aged between 2–16 years old. (3) Results: 58 studies were identified. They were discussed based on the languages used, the speech-synthesis systems and/or methods used, the speech data used, the intelligibility of the speech and the ages of the voices. Based on the reviewed studies, relative to adult-speech synthesis, developing child-speech synthesis is notably more challenging. Child speech often presents with acoustic variability and articulatory errors. To account for this, researchers have most often attempted to adapt adult-speech models, using a variety of different adaptation techniques. (4) Conclusions: Adapting adult speech has proven successful in child-speech synthesis. It appears that the resulting quality can be improved by training a large amount of pre-selected speech data, aided by a neural-network classifier, to better match the children’s speech. We encourage future research surrounding individualised synthetic speech for children with CCN, with special attention to children who make use of low-resource languages.
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    Stories of school reintegration following traumatic brain injury (TBI): The experiences of children, their primary caregivers and educators in the Western Cape
    (2015) De Villiers, Amy Jane; Kathard, Harsha; Togher, Leanne; Harty, Michal
    Focus of study and background to the problem: The study focuses on the experiences of children with traumatic brain injury (TBI), their parents and educators of being back at school. TBI is a major health concern in South Africa (SA). Children who sustain a TBI have significant, but often hidden, disorders which affect their learning and social interaction. The South African government endorses a policy of inclusive education (IE); however, the educational environment is stressed and overburdened. Little is known both internationally and in SA about the children's experiences, and the experiences of their parents and educators. Aims: The study has one main aim which is to explore and describe the experience of being back at school of children with TBI, their parents and educators. Methodology: A narrative case study design was used, consisting of two cases of 3 participants each (child with TBI, his parent and educator). Children were aged between 10 and 12 years. Data were collected using multiple open ended interviews. Data analysis was a complex and iterative process across 3 levels. Results: Results are presented across the levels of analysis. Firstly, six individual participant research stories are presented. Secondly, the emergent themes per participant type are given and discussed and finally a multiperspective combined theme is discussed. Conclusion: The experience of being back at school following TBI is a struggle as a policy of IE is expected to be practiced in an unsupported system. The children provided a voice previously lacking in the literature. There was evidence of inclusion being driven from the ground up by parents and educators. Implications of the study for policy makers, rehabilitation and educational professionals are given. A broader view of inclusion is advocated.
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    The applicability of implementing Enhanced Milieu Teaching (EMT) with young children with developmental disabilities who reside in the Western Cape and speak Afrikaans or IsiXhosa at home: parent and professional perspectives
    (2019) du Plessis, Chevonne; Harty, Michal; Hampton, Lauren H
    Background: Enhanced Milieu Teaching (EMT) is an evidence-based naturalistic developmental behavioural intervention (NDBI) to improve expressive communication. EMT produces favourable long-term results in both vocabulary growth and linguistic structure after a relatively short intervention period. However, very little research has been conducted to prove its effectiveness in culturally and linguistically diverse populations. Furthermore, before interventions can be implemented in different contexts, there is a need to determine if any adaptations are needed to maximize the fit of the intervention to the novel context. Tension exists between the need for implementation fidelity and the flexibility or fit of an intervention into novel settings, populations and contexts. A single proof of concept study exists which indicates that a trained therapist can implement EMT to fidelity in a South African special school context with English-speaking children. However, very little research exists which documents stakeholder perspectives of the perceived fit of naturalistic developmental behavioural interventions in the South African context. This study adds to this important body of literature by documenting the perceptions of bilingual Speech and Language Therapists, as well as bilingual parents of children with developmental disabilities, regarding the applicability of EMT within the South African context. Aim: To determine bilingual parents’ and Speech and Language Therapists’ perceptions regarding the acceptability and appropriateness of implementing EMT with young children with developmental disabilities who reside in the Western Cape and speak Afrikaans or isiXhosa at home. Methods: A descriptive exploratory study was conducted using two qualitative methods. Five bilingual SLT’s were interviewed, and two focus groups with eleven bilingual parents of children with developmental disabilities was conducted thereafter. Data was transcribed and analysed using thematic analysis according to the approach suggested by Braun & Clarke, (2006). The findings of the thematic analysis were then merged as subthemes within the adaptome framework (Chambers & Norton, 2016) in order to present diverse parent and SLT perspectives adequately. The adaptome framework comprises four sources of adaptations, namely: service setting, mode of delivery, target audience and cultural adaptations. vi Results: The barriers and facilitators to implementing EMT, together with the areas for potential adaptation within a multilingual and/or multicultural context, were reported in this study. Both parent and professional stakeholders reported that the core components of EMT are appropriate within their contexts and would not require adaptations. The data obtained from both parent and professional participants pertaining to potential adaptations were grouped into ten subthemes which were assigned within the four sources of adaptation. Bilingual SLTs highlighted aspects such as limited resources and limited parent-professional collaborations as barriers to sustained implementation across diverse service settings. Parents expressed concerns regarding the resources and the mode of intervention delivery used during EMT implementation. The facilitators and barriers, together with the areas for potential adaptation identified by the participants, align with perceptions of parents and professionals as reported in previous literature. Implications: Bilingual parent and professional stakeholder participants found that the core components of EMT would be appropriate in the South African context. However, participants suggested that adaptations to the peripheral elements of EMT would be required, with the majority of the adaptations relating to preferred service delivery settings and the mode of intervention delivery. Conclusion: Bilingual parents and Speech and Language Therapists view EMT as an appropriate and potentially valuable intervention in the South African context.
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    The effectiveness of a brief home-based naturalistic language intervention on the spoken language abilities of children with autism in the Western Cape
    (2022) Theron, Caroline; Harty, Michal
    Background: Naturalistic Developmental Behavioural Interventions (NDBIs) have shown to have a positive effect on cognitive and social outcomes of children with Autism Spectrum Disorder (ASD) though very few NDBIs have been implemented in low- and middle-income countries (LMIC). Challenges in accessing evidence-based interventions for many families of children with ASD living in LMIC exists due to the cost of travel, the remote locations of services, limited availability of services, and/or the financial implications thereof. Providing intervention in the child with ASD's home context may be one way for children to access intervention services needed. Enhanced Milieu Teaching (EMT) has shown to be effective in providing support to language development in children from LMIC. This study expands on previous research and literature by examining the effectiveness of clinician-implemented EMT when administered in the home context of children with ASD in low-resource settings in Cape Town, South Africa. Objectives: The study's objectives were to determine; i) Does the use of clinician implemented EMT within the home environment of children with ASD living with their families in the Metropolitan area of Cape Town, Western Cape increase the child's communication abilities, in particular the number of different words a child uses, ii) Do the communication gains made during the intervention generalise to the child's spoken language interactions with their primary caregivers? Methods: A single case study with multiple baseline design examined the effects of clinician-implemented home-based EMT intervention on the diversity and frequency of spoken language of young children with ASD in South Africa. Intervention sessions occurred in the homes of three young children with ASD between the ages of 45 and 72 months. Each participant presented with minimally verbal language abilities producing 1 word or less per minute at the start of the study, with an age equivalent of 20 months for their expressive language on the PLS-5. The participants received a minimum of 12 bi-weekly intervention sessions within their home context. Results: A 10-minute segment for each session was transcribed and coded using the Systematic Analysis of Language Transcripts (SALT; Miller & Chapman, 2008) using a prescribed EMT code. Results from the baseline and intervention sessions tracked the number of different words (NDW) used by the participants and was graphed to determine the effect of introducing the EMT intervention on the dependent variable. A functional relationship was demonstrated between the introduction of EMT and the increases in the NDW used for the three participants. The percentage of nonoverlapping data between the baseline and intervention sessions was above 92% for all participants. Evidence of generalisation of their spoken language abilities to interactions with their parents were observed. Conclusion: A functional relationship between the introduction of the EMT intervention and the increase in the participant's spoken language abilities indicated that EMT may be effective for improving spoken language skills of minimally verbal children with ASD when implemented in the home context by a trained clinician. Providing intervention services within a child with ASD's home context in South Africa is feasible and offers some relief from the logistical and financial strain placed on families of children with ASD in accessing services. The current findings may assist in determining ways to train parents in the implementation of EMT within their home context.
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    The effectiveness of a caregiver-directed intervention promoting development in HIV-positive children on caregivers' self-efficacy: A randomised controlled trial
    (2018) Ferguson, Jessica; Gretschel, Pam; Harty, Michal
    Background: Caregiver self-efficacy (CSE) supports the capabilities of caregivers to engage in parenting activities including stimulating development in their children. Human immunodeficiency virus (HIV) remains a prevalent concern in South Africa, even with the use of antiretroviral treatment. Children with HIV are compromised in their health and development which adds to the general stress of families rearing HIV-positive children. Stress has a negative effect on CSE. However, studies indicate that CSE can be improved through parent-mediated intervention. Caregivers’ engagement in the intervention may grow their skills to promote development in their HIV-positive children. This may have a positive influence on CSE. Occupational therapists working in governmental paediatric HIV clinics developed a play-informed, caregiver-implemented, home-based intervention (PICIHBI) for HIV affected families to be implemented. This study evaluates the effectiveness of PICIHBI on CSE. Aim: The aim of the study is to determine if the CSE levels in a group of caregivers of HIV-positive children aged 6 months to 8 years 0 months on ART, after receiving play-informed caregiver-implemented home-based intervention (PICIHBI) are not inferior to CSE levels in an equivalent group of caregivers with children receiving conventional one-on-one occupational therapy. Method: The study applied a pragmatic, randomised control trial with caregiver-child dyads attending the antiretroviral clinic at Groote Schuur Hospital, Cape Town. The control group received conventional child-directed occupational therapy on an individual basis and the experimental group received caregiver-directed, PICIHBI in a group format. The Parenting Self-Efficacy Measure (P-SEMI), Parenting Sense of Competency (PSOC) scale, and the General Self-Efficacy Scale (GSE) measured self-efficacy at baseline, half way and at the end of the yearlong, monthly interventions. Results: Sixty-four caregiver-child dyads were recruited and assessed at baseline. Thirty-nine dyads were retained in the study, completing the measures at all three test points. Results revealed that baseline CSE was high for both groups. There was a significant change (p < .001) in the P-SEMI total scale in both groups from baseline to mid-test and mid-test to post-test. In both groups the CSE scores decreased from baseline to mid-test and then increased from mid-test to post-test. There was not a significant difference in CSE results between baseline and post-test on the P-SEMI total scale for either groups. There were no significant differences between test points for the other scales and subscales for both groups. Conclusion: The results suggest that PICIHBI has a non-inferior effect on CSE to that of conventional occupational therapy. This suggests that PICIHBI is comparable to conventional occupational therapy and could be implemented as an alternative intervention without comprising the effects on CSE. Employing PICIHBI as an alternative intervention could provide a number of benefits including the development of caregiver skills, a larger reach within the population, and contextually driven intervention that is embedded in children’s home environments. Various influencing factors are proposed to explain the patterns of CSE demonstrated in the groups. Neither group showed a significant increase in CSE from baseline to post-test and thus further investigation and intervention development is required to specifically demonstrate enhanced CSE in this context. Intervention attendance for both groups was poor. This is the first investigation on the effects of PICIHBI on CSE which can inform further research to develop best occupational therapy practice in the vast population of HIV affected families.
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    The health and well-being of caregivers raising children with and without autism spectrum disorder in the South African context
    (2022) Smith, Louise; Harty, Michal; Schlebusch, Liezl
    Background: Children require a nurturing environment to develop optimally and reach their full potential. A critical component of this environment is the health and well-being of caregivers so that they can provide responsive caregiving. It is believed that parents or caregivers of children with ASD will have poorer health and well-being than parents or caregivers of children without ASD. Therefore, parents of children with ASD may require more support to enable them to provide responsive caregiving to these children. Methods: This study was a quantitative study that employed an analytical, comparative design. The purpose of this study is to determine if there is a significant difference in the health and well-being of parents with children with ASD and parents of children without ASD in the South African context. Two hundred and eight participants from two schools in Kwa-Zulu Natal completed a paper-based survey containing 3 questionnaires relating to health-related quality of life; stress, anxiety and depression and parental self-efficacy. Parenting constructs such as stress, anxiety and parental self-efficacy are measured and described, and the association between Health-related Quality of Life and constructs such as stress, anxiety and parental self-efficacy is explored. It took place at a special needs school in KZN and mainstream school in the same district. Results: The results of this study demonstrated a poorer HRQOL in some of the areas of parents of a child with ASD compared to parents of a child without ASD. The results from this study demonstrate the importance for health practitioners to focus on the parents' health and well-being as part of the child's intervention. Conclusion: Intervention is mainly child-focussed however it is important for practitioners to understand the caregiver's health and well-being as this will have a positive influence of the child and in turn, lead to successful intervention. It is therefore important to have a family-centred approach. The QOL of the parents or caregivers of children with ASD will improve through support and intervention which will positively impact on the child's development. If the caregiver is receiving the appropriate support, their QOL will improve and they will be able to provide nurturing care that the child needs.
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    Vocabulary used by ethno-linguistically diverse South African toddlers: a parent report using the language development survey
    (OASIS Publishing, 2013) Gonasillan, Aurellia Shamaleni; Bornman, Juan; Harty, Michal
    Objective: The primary aim of this study was to ascertain the relevance of the vocabulary of the Language Development Survey (LDS) for typically developing South African toddlers who attend ethno-linguistically diverse early childhood development centres. Rationale: The need for exploration of the expressive vocabulary of this population stems from the diverse linguistic contexts to which toddlers are exposed on a day-to-day basis in South Africa. Many parents prefer English as the language of learning and teaching for their child. As a result, toddlers interact with ethno-linguistically diverse peers from a young age, usually within their early childhood development centres. Method: An adapted version of the LDS was presented to 40 middle-class parents in Mpumalanga. Vocabulary commonly used by toddlers was determined and a comparison of parent responses made between the present study and the original American-based survey. Results: Results revealed that nouns were used most often by toddlers, in keeping with research on vocabulary acquisition. Significant correlations between the two groups were evident in 12 of the 14 categories. Parents reported that nouns, verbs, adjectives and words from other word classes were used similarly by toddlers, despite differences in their linguistic exposure. Conclusions: These findings suggest that the LDS is a valuable clinical screening tool for speech-language therapists who deliver services to toddlers within the South African context.